CHANGES IN ADULT SIBLING CONFLICT AND OLDER PARENTS’ COGNITIVE IMPAIRMENT: THE MODERATING ROLE OF CARE PROVISION

Abstract The life course concept of “linked lives” emphasizes that the life events of one family member have implications for other family members. Health events have been shown to be particularly salient in later-life families. We considered the consequences of older parents’ cognitive impairment on adult sibling relationship quality. Using mixed methods data from 327 adult children (nested within 96 families) collected as part of the Within-Family Differences Study (WFDS) T3, we examined the role of adult children’s care provision in the association between parents’ cognitive impairment and adult sibling tension. At T3 of the WFDS, the adult children were on average 60 years old and their parents were on average 90 years old. We conducted lagged multilevel linear regression modeling to account for nonindependence and to control for sibling tension seven years earlier before parents were experiencing cognitive impairment. The results of the quantitative analyses revealed that reports of sibling tension were higher in families in which parents experienced cognitive impairment. Moderation analyses indicated that the association between parents’ cognitive impairment and sibling tension was stronger for caregivers than noncaregivers. Qualitative analyses revealed that discrepancies in perceptions of the caregiving situation between caregivers and noncaregivers fueled sibling tension. Noncaregivers often seemed unaware of the caregiving situation or actively disengaged to avoid conflict. Taken together, these findings indicate that sibling tension is particularly high in the context of caring for older parents with cognitive impairment. In particular, adult children who are providing care are at increased risk of sibling tension.

China (People's Republic),2. New York University,New York City,New York,United States This study utilized data from the "2019 New Era and Living Conditions in Megacities Survey" to investigate social structural disparities in dental care utilization among adults aged 18-65 from 10 megacities in China.Logistic regressions were conducted to examine the relationships between social structural factors, such as hukou status, occupational status, migrant status, and city of residence, and dental care utilization.Margins post estimation was used to explore whether the social structural disparities in dental care utilization were associated with changes in oral health status.Results showed that only 22.36% of participants had at least one dental visit per year.Having urban hukou as compared with rural hukou (OR, 1.76; 95% CI, 1.47-2.12),working in state-owned enterprise as compared with in other enterprises (OR, 1.34; 95% CI, 1.14-1.57),and living in more developed cities as compared with in less developed cities (OR, 1.48; 95% CI, 1.27-1.72)were associated with a higher likelihood of regular dental visits.Additionally, participants with urban hukou and those living in more developed cities were more likely to have regular dental visits when their oral health was good, such as when they had full natural teeth.This study highlights social structural disparities in oral health behaviors among adults in China's megacities.The findings suggest that efforts should be made to improve dental care utilization by promoting public messaging about oral health knowledge, expanding dental care coverage, and improving access to dental care services in China.

ALZHEIMER'S DISEASE AND RELATED DEMENTIAS IN A FAMILY CONTEXT
Chair: J Jill Suitor Co-Chair: Megan Gilligan This symposium considers the ways in which the presence of Alzheimer's Disease and Related Dementias (ADRD) shapes functional and affective relationships between family members, and raises questions about the future public health implications of ADRD family caregiving.In the first paper, Huo and Kim use dyadic data collected from husbands and wives in which one partner lives with mild-to-moderate cognitive AD to explore the role of relationship quality in caregiver stress.Next, Suitor and colleagues use mixed-methods data from the Within-Family Differences Study to examine how mothers' cognitive impairment moderates the impact of maternal favoritism/disfavoritism on the psychological well-being of adult sons and daughters.Third, Gilligan, Suitor and Ogle investigate the role of adult children's care provision in the association between parents' cognitive impairment and adult sibling tension, also using mixedmethods data from the WFDS.Next, Savla and Roberto use mixed-methods data to explore how extended family caregivers manage their care responsibilities and how care arrangements impact the provision of future care for persons living with ADRD.Finally, Gaugler considers the public health ramifications of family caregiving, summarizing the scientific literature on estimating the future supply of family caregivers, and presenting a research agenda to address the potential family care gap.Taken together, this diverse set of papers highlights the complex ways in which the presence of ADRD shapes patterns of care, relationship quality, and well-being of members of later-life families.This is a collaborative symposium between the Alzheimer's Disease and Related Dementias and Family Caregiving Interest Groups.
Abstract citation ID: igad104.0054Suitor 1 , Megan Gilligan 2 , Robert Frase 3 , Destiny Ogle 1 ,  and Ranran He 4 , 1 Parental differential treatment has been shown to have a negative impact on adult children's psychological well-being, particularly among daughters.In this paper, we explore whether mothers' cognitive impairment (CI) moderates the impact of maternal favoritism/disfavoritism on psychological well-being when children are entering their later years (M=60), and their mothers are in their 80s-90s.We address these questions using mixed-methods data from 297 adult children who participated in wave 3 of the Within-Family Differences Study.Quantitative and qualitative analyses revealed that the effects of perceived favoritism/ disfavoritism were shaped by the combination of child's gender and mothers' CI status.Perceptions of disfavoritism, particularly regarding mothers' disappointment, affected daughters' depressive symptoms; however, the effect was decidedly muted by mothers' CI.In the case of mothers' preferences regarding their future caregivers, the differences by cognitive status were particularly striking.Contrary to expectations, daughters' perceptions that they were their mothers' preferred caregivers predicted depressive symptoms when mothers showed no signs of CI, but had no impact when mothers were cognitively impaired.Among sons, depressive symptoms were not affected by mothers' favoritism or disfavoritism, regardless of mothers' CI status; a gender difference in the impact of mothers' appraisals on well-being that we have seen emerge across the 20 years we have followed these families.Qualitative analyses suggest that mothers' CI reduced daughters' emotional reactions to their mothers' differential treatment because they believed that their mothers had less control of their behaviors and less awareness of the negative impact of their appraisals and expectations.The life course concept of "linked lives" emphasizes that the life events of one family member have implications for other family members.Health events have been shown to be particularly salient in later-life families.We considered the consequences of older parents' cognitive impairment on adult sibling relationship quality.Using mixed methods data from 327 adult children (nested within 96 families) collected as part of the Within-Family Differences Study (WFDS) T3, we examined the role of adult children's care provision in the association between parents' cognitive impairment and adult sibling tension.At T3 of the WFDS, the adult children were on average 60 years old and their parents were on average 90 years old.We conducted lagged multilevel linear regression modeling to account for nonindependence and to control for sibling tension seven years earlier before parents were experiencing cognitive impairment.The results of the quantitative analyses revealed that reports of sibling tension were higher in families in which parents experienced cognitive impairment.Moderation analyses indicated that the association between parents' cognitive impairment and sibling tension was stronger for caregivers than noncaregivers.Qualitative analyses revealed that discrepancies in perceptions of the caregiving situation between caregivers and noncaregivers fueled sibling tension.Noncaregivers often seemed unaware of the caregiving situation or actively disengaged to avoid conflict.Taken together, these findings indicate that sibling tension is particularly high in the context of caring for older parents with cognitive impairment.In particular, adult children who are providing care are at increased risk of sibling tension.

MATERNAL DIFFERENTIAL TREATMENT AND ADULT CHILDREN'S DEPRESSIVE SYMPTOMS IN THE FACE OF COGNITIVE IMPAIRMENT J Jill
Abstract citation ID: igad104.0056Various societal trends and expanded family boundaries have led to a broad array of family members involved in caring for persons living with dementia (PLwD).We examined how extended family caregivers (FCG) manage their care responsibilities and how the care arrangement impacts the provision of future care for PLwD.Mixed-method data from 48 extended FCG and 56 nuclear FCG (71% White, 68% female, 63% co-reside with PLwD) revealed that 70% of extended FCG rely on informal helpers to care for PLwD.Spouses and daughters were more often sole caregivers while most sons relied on informal helpers.If no longer able to help, sisters, granddaughters, and nieces more likely foresaw moving PLwD to a care facility, whereas brothers, grandsons, and nephews anticipated another informal helper would assume their care.Extended FCG often expressed dissatisfaction with one or more informal helpers for failing to meet care responsibilities, potentially leading to unmet needs and increased risk for early nursing home placement for the PLwD.The discussion will focus on the attributes of informal helpers of extended FCG that contribute to stable or inconsistent care arrangements for PLwD, which can ultimately affect the well-being of PLwD and FCG.When considering the public health ramifications of family caregiving, a major concern is the future supply of family, friends, or other unpaid caregivers (hereafter referred to as family caregivers) of older persons with health needs.This presentation will summarize the state of the science on estimating the future "supply" of family caregivers for older persons, and whether there are structural or social determinants, in addition to long-standing socio demographic trends, which may contribute to the family care gap.In addition, the presentation will outline a potential research agenda on the family care gap that summarizes the potential implications of this phenomenon as well as how it aligns with efforts to elevate family caregiving for older people (particularly those living with dementia) as a matter of public health import.People living with Alzheimer's disease (AD) typically receive considerable support from their spousal caregivers.Yet, we know little about whether people with early-stage AD may still be able to help their caregivers and how potential support exchanges in these couples may vary depending on the quality of their relationships.We drew on dyadic data from 37 older couples in which one partner lives with mildto-moderate AD (Mage = 77yrs, 48% male) and the other serves as a spousal caregiver (Mage = 76yrs, 53% female).Couples participated in concurrent interviews during which they each reported on a variety of demographic and relationship characteristics, such as relationship quality, and couple support exchanges.People with early-stage AD perceived their relationships with spousal caregivers as more positive and less negative than did these caregivers.Support did not flow unidirectionally in these caregiving couples, especially not among those in better-quality relationships.Specifically, caregivers who viewed their relationships as more positive/ less negative considered it less stressful to provide emotional and practical support to their partners with AD.Patients who viewed their relationships as more positive/less negative provide more frequent emotional and practical support to their caregivers and also found such support provision more pleasant and less stressful.Findings reveal positive contribution that older adults with dementia, who have been solely treated as recipients of care, can make and shed light on the development of dyadic interventions by highlighting the importance of mutually beneficial relationships in early stages of AD.

WHO'S UP NEXT? EXTENDED FAMILY CAREGIVERS OF PERSONS LIVING WITH DEMENTIA: CURRENT AND FUTURE CARE
. Purdue University, West Lafayette, Indiana, United States, 2. University of Missouri, Columbia, Missouri, United States, 3. Southern Illinois University, Carbondale, Illinois, United States, 4. Sociology, West Lafayette, Indiana, United States Tina Savla 1 , and Karen Roberto 2 , 1. Virginia Tech, Blacksburg, Virginia, United States, 2. Virginia Polytechnic Institute & State University, Blacksburg, Virginia, United States